Project Summary/Abstract "Reducing Asthma Disparities: The Baltimore City Healthy Homes Initiative" (RAD) will reduce racial disparities in asthma morbidity in Baltimore by providing an evidence- based healthy homes intervention to the families of 250 Baltimore Public School students aged 4-18 who have persistent asthma. The RAD Initiative is a translation research project, adapting the effective Seattle-King County (SKC) model. The SKC Healthy Homes program has significantly reduced asthma symptom days and urgent health service usage (Krieger et al., 2005). We will enhance the SKC intervention to address risks specific to Baltimore through: 1) maternal depression screening and referrals, 2) strengthened rodent reduction measures, 3) lead poisoning prevention, 4) additional injury prevention, 5) motivational interviewing to reduce environmental tobacco smoke, and 6) recruitment through the schools. This translation research will compare and contrast the intervention costs, medical costs, home environmental health outcomes and children's asthma-related health outcomes in 250 intervention children and a comparable group of 250 non-intervention Medicaid enrolled children with persistent asthma. The RAD Initiative will be lead by the Baltimore City Health Department's Healthy Homes Division, whose mission is to improve the health of children and their families by reducing housing hazards tied to asthma, lead exposure, and injuries. In addition to helping the BCHD achieve its long-term goal of reducing asthma disparities, the RAD Initiative's specific aims include, first, disseminating project findings broadly to city, state, and national stakeholders through a Baltimore community conference, student-produced video, journal articles, community and conference presentations, and web-based information and materials. Second, the RAD Initiative will identify mechanisms by which the program can be sustained over time and scaled up to address the needs of all at-risk Baltimore families of children with asthma. Third, the RAD Initiative aims to use a coordinated, public-private partnership approach to extend the reach of healthy homes home visiting programs. The RAD Initiative represents the alliance of two universities, two city agencies, the state, Baltimore City's congressional delegation, a youth-focused social action organization, an asthma coalition, and a coalition of African-American charities. PUBLIC HEALTH RELEVANCE: Project Narrative By adapting the Seattle King County Healthy Homes approach to the Baltimore environment and new research findings, we aim to reduce disparities related to childhood asthma, lead poisoning, and injuries. Baltimore's unsafe housing is harmful to the city's most vulnerable residents. Our "Reducing Asthma Disparities" Initiative will demonstrate a new systems approach to diffusing an effective intervention to reach underserved families with children with chronic asthma to significantly reduce health disparities in Baltimore.